[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR410.46]



[Page 341]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 410_SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS--Table of Contents

 

               Subpart B_Medical and Other Health Services

 

Sec. 410.46  Physician and other practitioner services furnished in 

or at the direction of an IHS or Indian tribal hospital or clinic: 

Scope and conditions.



    (a) Medicare Part B pays, in accordance with the physician fee 

schedule, for services furnished in or at the direction of a hospital or 

outpatient clinic (provider-based or free-standing) that is operated by 

the Indian Health Service (IHS) or by an Indian tribe or tribal 

organization (as those terms are defined in section 4 of the Indian 

Health Care Improvement Act). These services are subject to the same 

situations, terms, and conditions that would apply if the services were 

furnished in or at the direction of a hospital or clinic that is not 

operated by IHS or by an Indian tribe or tribal organization. Payments 

include health professional shortage areas incentive payments when the 

requirements for these incentive payments in Sec. 414.42 of this 

chapter are met.

    (b) Payment is not made under this section to the extent that 

Medicare otherwise pays for the same services under other provisions.

    (c) Payment is made under these provisions for the following 

services:

    (1) Services for which payment is made under the physician fee 

schedule in accordance with part 414 of this chapter.

    (2) Services furnished by non-physician practitioners for which 

payment under Part B is made under the physician fee schedule.

    (3) Services furnished by a physical therapist or occupational 

therapist, for which payment under Part B is made under the physician 

fee schedule.

    (d) Payments under these provisions will be paid to the IHS or 

tribal hospital or clinic.



[66 FR 55329, Nov. 1, 2001]